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Home My WebLink AboutRBPR-07-2014-19417.TIFApplicant THIS IS NOT A PERMIT Case # RBPR-07-2014-19417 CATAWBA COUNTY HEALTH DEPARTMENT PLAN REVIEW APPLICATION FOR ENVIRONMENTAL SERVICES Residential Building Plan Review - Accessory Structure SAME AS OWNER, , IMPROVEMENT �J;p ❑1 Owner ERIC BROWN, 3563 BETHANY CHURCH RD, CLAREMONT NC 28610 C:8283817659 NAME TO APPEAR ON PERMIT ERIC BROWN SITE ADDRESS: 3563 BETHANY CHURCH RD, CLAREMONT NC 28610 PIN # 376118301985 NAME of SUBDIVISION: COOKLAND HEIGHTS 2-15 & 28-31 Lot #� Section/BlockA PROPERTY SIZE: Square Feet Acres 0.92 DIRECTIONS: Take Hwy 10 East to bethany Church Rd Turn Left onto Bethany Church Rd House will be about a1 1/2 on your Ift PRIMARY CONTACT:ne SEWER TYPE: Septic Tank GALLONS PER DAY: 24U WATER SUPPLY: Private Well DESCRIBE WORK: 18 x2-0 etal Storage Building SITE INFORMATION Do any of the following apply to the property for which this application is applied? If the answer to any of the questions below is "YES", then supporting documentation is required: Does this site contain any jurisdictional wetlands? No Does this site contain any existing wastewater systems? Yes Is any of the wastewater going to be generated on the site other than domestic sewage? No Is the site subject to approval by any other public agency? Yes Are there any easements or right-of-ways on this property? No APPLICATION FOR: STRUCTURE TYPE: FACILITY TYPE: Single Family Residence New Structure ACCESSORY STRUCTURE OTHER DESCRIPTION: DESCRIPTION OF House EXISTING STRUCTURES ON SITE (IF ANY) DIM EXISTING STRUCTURE: 55 x 28 NUMBER OF EXISTING BEDROOMS: 2 # OF OCCUPANTS: 2 PROPOSED CONSTRUCTION NEW STRUCTURE DIM:: 18 x 20 Desired system types (Improvement Permit or Authorization to Construct): ACCEPTED: ALTERNATIVE: CONVENTIONAL: OTHER: INNOVATIVE: ANY: YES Other described: Improvement Permits issued as a result of this information are valid for 5 years or may be non -expiring under certain specified conditions. An Authorization to Construct issued by this department is valid for (5) five years from the date issued and is not transferable; Improvement Permits and Well Permits are transferrable. Permits may be revoked if the information on this application, site plans or intended use changes for the proposed facility. I have read this application and certify that the information provided herein is true, complete and correct. Authorized county and state officials are granted right of entry to conduct necessary inspections to determine compliance with applicable laws and rules. I understand that I am solely responsible for the proper identification and labeling of all property lines and corners and making the site accessible so that a complete site evaluation can be performed. Date: Signature of Applicant or Agent An Environmental Health Specialist will contact you within 2 working days of application date. If you need further information or assistance please call 828-466-7291 AREA2 MINIMUM SETBACKS FRONT: 30 SIDE: 10 REAR: 5 MAX HEIGHT: F9 - ehapplication 07/08/2014 07:44 Page 1 of 4 Applicant THIS IS NOT A PERMIT Case # RBPR-07-2014-19417 CATAWBA COUNTY HEALTH DEPARTMENT PLAN REVIEW APPLICATION FOR ENVIRONMENTAL SERVICES Residential Building Plan Review - Accessory Structure SAME AS OWNER, , IMPROVEMENT 0 E Owner ERIC BROWN, 3563 BETHANY CHURCH RD, CLAREMONT NC 28610 C:8283817659 NAME TO APPEAR ON PERMIT ERIC BROWN SITE ADDRESS: 3563 BETHANY CHURCH RD, CLAREMONT NC 28610 PIN # 376118301985 NAME of SUBDIVISION: COOKLAND HEIGHTS Lot) 2-15 & 28-31 Section/Block A PROPERTY SIZE: Square Feet Acres 0.92 DIRECTIONS: Take Hwy 10 East to bethany Church Rd Turn Left onto Bethany Church Rd House will be about al 1/2 on your Ift PRIMARY CONTACT: Owner SEWER TYPE: Septic Tank GALLONS PER DAY: 480 WATER SUPPLY: Private Well DESCRIBE WORK: 18 x 20 Metal Storage Building SITE INFORMATION Do any of the following apply to the property for which this application is applied? If the answer to any of the questions below is "YES", then supporting documentation is required: Does this site contain any jurisdictional wetlands? No Does this site contain any existing wastewater systems? Yes Is any of the wastewater going to be generated on the site other than domestic sewage? No Is the site subject to approval by any other public agency? Yes Are there any easements or right-of-ways on this property? No APPLICATION FOR: New Structure STRUCTURE TYPE: CCESSORY STRUCTURE FACILITY TYPE: Single Family Residence OTHER DES TI DESCRIPTION OF House EXISTING STRUCTURES ON SITE (IF ANY) DIM EXISTING STRUCTURE: 55 x 28 NUMBER OF EXISTING BEDROOMS: 2 # OF OCCUPANTS: 2 PROPOSED CONSTRUCTION NEW STRUCTURE DIM:: 18 x 20 Desired system types (Improvement Permit or Authorization to Construct): ACCEPTED: ALTERNATIVE: CONVENTIONAL: OTHER: INNOVATIVE: ANY: YES Other described: Improvement Permits issued as a result of this information are valid for 5 years or may be non -expiring under certain specified conditions. An Authorization to Construct issued by this department is valid for (5) five years from the date issued and is not transferable; Improvement Permits and Well Permits are transferrable. Permits may be revoked if the information on this application, site plans or intended use changes for the proposed facility. I have read this application and certify that the information provided herein is true, complete and correct. Authorized county and state officials are granted right of entry to conduct necessary inspections to determine compliance with applicable laws and rules. I understand that I am solely responsible for the proper identification and labeling of all property lines and corners and making the site accessible so that a complete site evaluation can be performed. Date: Signature of Applicant or Agent An Environmental Health Specialist will contact you within 2 working days of application date. If you need further information or assistance please call 828-466-7291 AREA2 E9 - ehapplication 07/07/2014 17:19 Page 1 of 4 �A THIS IS NOT A PERMIT Case # RBPR-07-2014-19417 CATAWBA COUNTY HEALTH DEPARTMENT 0 f❑' V®� C PLAN REVIEW APPLICATION FOR ENVIRONMENTAL SERVICES 1842 sM Residential Building Plan Review - Accessory Structure IMPROVEMENT 0 Applicant SAME AS OWNER, , Owner ERIC BROWN, 3563 BETHANY CHURCH RD, CLAREMONT NC 28610 C:8283817659 NAME TO APPEAR ON PERMIT - - I Lei I # U-smT 1111 SITE ADDRESS: 3563 BETHANY CHURCH RD, CLAREMONT NC 28610 PIN # 376118301985 NAME of SUBDIVISION: COOKLAND HEIGHTS LoA2-15 & 28-31 Section/Block A PROPERTY SIZE: Square Feet Acres 0.92 DIRECTIONS: Take Hwy 10 East to bethany Church Rd Turn Left onto Bethany Church Rd House will be about a1 1/2 on your Ift PRIMARY CONTACT: Owner SEWER TYPE: Septic Tank GALLONS PER DAY: 480 WATER SUPPLY: Private Well DESCRIBE WORK: 18 x 20 Metal Storage Building SITE INFORMATION Do any of the following apply to the property for which this application is applied? If the answer to any of the questions below is "YES", then supporting documentation is required: Does this site contain any jurisdictional wetlands? No Does this site contain any existing wastewater systems? Yes Is any of the wastewater going to be generated on the site other than domestic sewage? No Is the site subject to approval by any other public agency? Yes Are there any easements or right-of-ways on this property? No APPLICATION FOR: New Structure STRUCTURE TYPE: FACILITY TYPE: Single Family Residence DESCRIPTION OF House EXISTING STRUCTURES ON SITE (IF ANY) DIM EXISTING STRUCTURE: 55 x 28 NUMBER OF EXISTING BEDROOMS: 2 PRIMARY RESIDENCE OTHER DESCRIPTION: # OF OCCUPANTS: 2 PROPOSED CONSTRUCTION NEW STRUCTURE DIM:: 18 x 20 Desired system types (Improvement Permit or Authorization to Construct): ACCEPTED: ALTERNATIVE : CONVENTIONAL: OTHER: INNOVATIVE: ANY: YES Other described: Improvement Permits issued as a result of this information are valid for 5 years or may be non -expiring under certain specified conditions. An Authorization to Construct issued by this department is valid for (5) five years from the date issued and is not transferable; Improvement Permits and Well Permits are transferrable. Permits may be revoked if the information on this application, site plans or intended use changes for the proposed facility. I have read this application and certify that the information provided herein is true, complete and correct. Authorized county and state officials are granted right of entry to conduct necessary inspections to determine compliance with applicable laws and rules. I understand that I am solely responsible for the proper identification and labeling of all property lines and corners and making the site accessibl so that a co fete site evaluation can be performed. Date: '7117,114 Signature of Applicant or Agent An Environmental Health Specialist will contactyou within 2 or ing days of application date. If you need further information or assistance please call 828-466-7291 AREA2 E9 - ehapplication 07/07/2014 14:17 Page 1 of 4 CATAWBA COUNTY Case # RBPR-07-2014-19417 Public Health Department Subdivision COOKLAND HEIGHTS Environmental Health Division PIN# 376118301985 vq®v PO Box 389, 100-A Southwest Blvd, Newton, NC 28658 184 NAME ON PERMIT: ( ERIC BROWN), 3563 BETHANY CHURCH RD, CLAREMONT NC 28610 ( ERIC BROWN) Site Address: 3563 BETHANY CHURCH RD, CLAREMONT NC 28610 Property Size: Square Feet Acres 0.92 Directions: Take Hwy 10 East to bethany Church Rd Turn Left onto Bethany Church Rd House will be about a1 1/2 on your Ift MINIMUM SETBACKS FRONT: 30 SIDE: 10 REAR: 5 MAX HEIGHT: FEENAME Improvement Permit Fee TOTAL FEES DATE FEE AMOUNT 07/07/2014 $150.00 $150.00 SYSTEM REDESIGN AND/OR RETRIP WILL INCUR AN ADDITIONAL CHARGE (SEE FEE SCHEDULE) E9 - ehapplication 07/07/2014 14:17 Page 2 of 4 )X TBATHIS IS NOT A PERMIT c'aLI TY' -_— CATAVVBA COUNTY HEALTH DEPARTMENT Application for Environmental Services Page 1 Improvement Permit ❑ Authorization to Construct ❑ Septic Repair ❑ Septic Malfunction ❑ Septic Expansion ❑ New Well Permit ❑ Replacement Well ❑ Well Abandonment ❑ Well Repair ❑ Existing System Inspection (Pre -Approval Required) IA,pplication is for New Construction E:1 Existing Facility F1Property Address .�5 l 3 �Eihany Church Pd . Subdivision —U=w 1n+ W. 2No iO Lot # Acres Sectio `n`l�/"�Block/PhrasQe, Driving Directions to Property W f';i'1'1(.�a' C 1urcl E,( '--TIIl00 � 0 ft�) &4YIq W Ual J1 kod 10, C� 61 a NAME TO APPEAR ON PERMIT? Q Owner ❑ Applicant ❑ Contractor Applicant Contact Information I Name Er1 G bmw n Address 35(03 Be-ihar)y Church Rd. , UOLfet)-)bf)f NC,;.a200 Phone &H Phone Owner Contact Information Name SC;111L' CSS (1p p i c cm+ l nh . Address Phone I Cell Phone Contractor Contact Information Name Address Phone , Cell Phone WHO WILL BE THE PRIMARY CONTACT? ❑ Owner ❑ Applicant ❑ Contractor Description of Existing Structure „ . son Site ��e, # of Bedrooms *t 2- Structure Dimensions. X a$ _ # of Occupants a, Basement ❑ Yes 2 No Basement Fixtures 0 Yes WNo The Applicant shall notify the 1 department upon submittal of s application if an of the following apply local health de artme this y ll pply to the property in question. If the answer to any question is "yes", applicant must attach supporting documentation. 11 Yes cvko Does the site contain any jurisdictional wetlands? e(Yes ApNo Does the site contain any existing wastewater systems? Vye es E2-fI0 Is any wastewater going to be generated on the site other than domestic sewage? s IWUN Is the site subject to approval by any other public agency? 10 Yes ®'No Are there any easements or right of ways on this property? Describe Existing water supply in use Individual Well ❑ Community Well ❑ Semi-PubliWY Wes ElCounty/City/Township Water Line Is a public water supply available? ** es El No If applying'for an Improvement Permit or Authorization to Construct, Please Indicate Desired System Type(s): (systems can be ranked in order of your preference) 0 Accepted 11 Alternative 0 Conventional 0 Innovative 0 Other 11 Any CATAWBA THIS IS NOT A PERMIT COUr_;Tr CATAWBA COUNTY HEALTH DEPARTMENT TMENT Application for Environmental Services Page 2 Proposed Facility Type ❑ Primary Residence ❑ New Residence ❑ Addition to Residence # of New Bedrooms *t Project Description Structure Dimensions # of Occupants Basement ❑ Yes ❑ No Basement Fixtures EJ Yes [2 No ❑ Accessory Structure(s) Describe e # of New Bedrooms *t if applicable �' Structure Dimsions X A0 # of Occupants 0 Accessory Dwelling ❑ Yes a No Plumbing ❑ Yes �] No Describe Plumbing Needed �] Multi -Family Residence # Units #Bedrooms per Unit*t Total # Bedrooms Structure Dimensions �J Food Service Specify Type # Seats Floor Space -Entire Food Service Facility (Sq Ft) # Employees per Shift # of Shifts Dining Area (Sq. Ft.) ❑ Business Specific Type of Business Retail Floor Space # of Employees per Shift # of Shifts ❑ Other Facility Type Specify If Church # of Seats Kitchen ❑ Yes ❑ No If Daycare Specify Occupancy Application for Well Construction/Abandonment/Repair Proposed Well Type ❑ Individual Well ❑ Semi -Public Well ❑ Community Well Abandonment Type ❑ Drilled ❑ Bored ❑ Dug ❑ Unknown Well Repair Requested ❑ Yes ❑ No Describe Calculated Design Flow, Commercial t Additional information may be required to determine design flow from certain facilities. This value will be determined during consultation with on-site staff. *Any room that will be intended for sleeping at the time of construction or for future consideration should be noted as a bedroom and counted on all applications. The number of bedrooms will be confirmed by rooms identified on house plans as a bedroom at the time of building permit issuance. This may prevent the need for septic system size increase in the future. t If structure is plumbed but no bedrooms, calculated design flow is required. ** If No, a well permit must be issued with the Authorization to Construct. SYSTEM REDESIGN AND/OR RETRIP WILL INCUR AN ADDITIONAL CHARGE (SEE FEE SCHEDULE) Improvement Permits issued as a result of this information are valid for 5 years or may be non -expiring under certain specified conditions. An Authorization to Construct issued by this department is valid for (5) five years from the date issued and is not transferable; Improvement Permits and Well Permits are transferrable. Permits may be revoked if the information on this application, site plans or intended use changes for the proposed facility. I have read this application and certify that the information provided herein is true, complete and correct. Authorized county and state officials are granted right of entry to conduct necessary inspections to determine compliance with applicable laws and rules. I understand that I am solely responsible for the proper identification and labeling of all property lines and corners and making the site accessible so that a complete site evaluation can be performed. Signature of Owner or Agent Date 14 Printed Name of Owner or Agent Aa ri 9 ruv6- Catawba County, North Carolina This map product was prepared from the Catawba County, NC, Geospatial Information System ]� Catawba County has made substantial efforts to ensure the accuracy of location and labeling information contained on this map. Catawba County promotes and recommends the independent verification of any data contained on this map product by the user. The County of Catawba, its employees, agents and personnel disclaim, and shall not be held liable for any and all damages, loss or liability, whether direct, indirect or consequential which arises or may arise from this map product or the use thereof by any person or entity. Selected Parcel Number: 3761-18-30-1985 1 inch = 60 feet Prepared for: -3�"`J/ 0 r 29 �f { .1985. yg= 8 to �. o; 1.39A- 9 � 23 1814 v 0743 / �;> �:., ti. ,15b. THIS IS NOTA LEGAL DOCUMENT / Date Saved: /11/201 �e0%49:11 PM CATAWBA COUNTY NC - Parcel Report Information Regarding Selected Parcel(s) Parcel ID:, 3761-18-30-1985 Nam6' ` BROWN ERIC SHAYNE Name2: Address: 3563 BETHANY CHURCH ROAD Address2: City: CLAREMONT State: NC Zip: 28610-9519 Account: Calc Acreage: 0.92 Tax Map: 074N 01024 LRK: 38527 Deed Book: 3185 Deed Page: 0590 Subdivision Name: COOKLAND HEIGHTS Subdivision Block: A Lots: 12-15 & 28-31 Plat Book: 10 Plat Page: 36 Building Number: 3563 Street Name: BETHANY CHURCH RD Site Zip: 28610 Township: NEWTON Fire Dist: CLAREMONT RURAL City/Tax: State Road: 1722 Total Bldgs Value: $61,900 Land Value: $15,400 Total Value: $77,300 Year Built: 1961 Year Remodeled: 2013 Last Sale Date: 8/29/2008 Last Sale Amount: $81,500 Neighborhood: 117 Watershed: WS -IV Protected Area Watershed Split: NO Voter Precinct: P22 E911 District: COUNTY Zoning: R-20 Zoning2: Zoning3: Zoning Split: N Zoning Overlay: WP -O Zoning District: COUNTY Split Zoning Dist: N Split Zoning Dist(1): 0 Split Zoning Dist(2): 0 School District: COUNTY Elementary School: CLAREMONT Middle School: RIVER BEND High School: BUNKER HILL School Split: NO P&Z Case Number: Census Tract 2010: 011401 Census Block 2010: 1064 Small Area Plan: CATAWBA Agricultural District: Printed: Monday, July 07, 2014 01:49 PM